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Massachusetts rates for HCPCS 99305

Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

Facilitymedian $151 · 10th–90th $126–$1910%20%10th90th$151Professionalmedian $141 · 10th–90th $102–$2340%10%20%10th90th$141$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $134.90 / $190.55
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $295.12 / $794.33
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $144.54 / $302.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $239.88 / $398.11
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $144.54 / $257.04
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $138.04 / $229.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $169.82 / $288.40
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $295.12 / $794.33
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $144.54 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $169.82 / $363.08